Mind-body Therapies- Use in chronic pain management

As humans, our minds play a key role in our day-to-day lives. Our mind, emotions and attention play a very important role in our experience of pain. In many patients with chronic pain, stress, fear and depression can amplify the perception of pain. Mind-body approaches may include progressive muscle relaxation, meditation, mindfulness based approaches, guided imagery, and yoga. General practitioners are well placed to recommend or provide a range of mind-body approaches to improve outcomes for patients with chronic pain.

Many patients with chronic pain experience stress, fear and depression. These emotions and mental states often act as aggravating factors for pain due to the potential for amplification of the perception of pain. Conditions associated with chronic pain include burnout, depression, chronic fatigue syndrome and fibromyalgia. However, humans experience with pain is not merely somatic; it varies according to our mental, emotional and physical make-up.

A range of mind-body approaches can be used in the management of chronic pain or also as a sole treatment; however, they are used more commonly as assistants to other therapies. The relaxation response may be associated with greater pain tolerance giving it the potential to:

Enhances the brain’s responsiveness to endorphins

Reduce inflammation

Cause muscle relaxation

Reduce hypervigilance and desensitize central pain pathways

Enhance mood and reduce and emotional reactivity to pain

Mindfulness based approaches involve both meditation and a way of living that develops acceptance, and reducing pain related arousal and reactivity. This meta-analysis reviewed 9 randomized clinical trails and of the nine, eight were found to suggest that guided imagery leads to a significant reduction in musculoskeletal pain.